Since its inception in 1988, the Duke-UNC Comprehensive Sickle Cell Center (CSCC) has become a vitally important resource, one that has made important contributions to: our respective institutions; the State of North Carolina; the national sickle cell effort; and perhaps most importantly our patients and their families. The goals of the CSCC are to: 1) foster and carry out basic, translational, clinical and patient services/outcomes research; 2) support the career development of young investigators with an interest in and commitment to research in the area of sickle cell disease; 3) provide state-of-the art comprehensive care to those patients with sickle cell anemia and the related hemoglobinopathies who are followed in our Center; and 4) provide ready access to specialized sickle cell-related educational, psychosocial, and clinical services to everyone in North Carolina. These goals will be accomplished by enhancing our leadership role in sickle cell-related research activities that are taking place at the bench, the bedside, and in our patient populations; by further developing as a national model the Sickle Cell Scholar Program with our remarkable record of attracting exceptional minority investigators into the field of sickle cell disease and then doing everything possible to assure their success; by continuing our commitment to provide primary and tertiary care to the well over 1400 children and adults who comprise our Center's sickle cell patient population; and by sustaining North Carolina's position as a national leader in the provision of education, outreach, and medical and psychosocial services to all sickle cell patients regardless of socioeconomic status. The director of the Duke-UNC CSCC and the PI of this grant application is Dr. Marilyn Telen, and the Associate Director and PI for the UNC site is Dr. Eugene Orringer. Together, Drs. Telen and Orringer have a long-standing record of collaboration, enjoy the full support of the senior leadership at both institutions, and will receive the benefit of advice and counsel from the Center's Internal Advisory Committee, as well as from a Scientific Advisory Board and an External Advisory Committee. Over the next five years, the CSCC will continue to draw upon the strong tradition of sickle cell research and the state-of-the art clinical resources that exist at both institutions. The Center will fulfill its outreach mission through community-based clinics, a close working relationship with the NC Sickle Cell Syndrome Program, and an ongoing partnership with a variety of governmental agencies. Finally, the CSCC will maintain its national leadership position in the enrollment of study subjects in sickle cell-related multi-center trials, many of which are carried out through the network of the comprehensive sickle cell centers